This letter to the editor from a physician about the failure of Oregon’s doctor-prescribed suicide guidelines to protect a vulnerable patient is poignant, but ultimately, irrelevant. All that matters is a desire to die by the patient coupled (for now) with a terminal diagnosis. From “Oregon’s Assisted Suicide Law Isn’t Working” published in the The Provence (BC, Canada):
I am a doctor in Oregon, where physician-assisted suicide is legal. I disagree that Oregon’s law has worked well. As one example, a few years ago, my patient, a 76-year-old man presented with a sore on his arm that turned out to be cancer. I referred him to a cancer specialist for evaluation and therapy. The patient was an avid hiker and as he went through his therapy, he became less able to do this activity and became depressed, which was documented in his chart. He expressed a wish for assisted-suicide to the cancer specialist, but rather than taking the time and effort to address his depression, or to contact me as his primary physician and as someone who knew him, she asked me to be the “second opinion” for his suicide.
I told her that I did not concur and that addressing his depression would be better than simply giving him a lethal prescription. Unfortunately, two weeks later my patient was dead from an overdose prescribed by this doctor. In most jurisdictions, suicidal ideation is interpreted as a cry for help. In Oregon, the only help my patient got was a lethal prescription intended to kill him. Don’t make Oregon’s mistake.
Dr. Charles J. Bentz, Oregon Health & Sciences University, Portland, Ore.
I can hear yawning.
Here’s the problem, legalizing assisted suicide changes mindsets 180 degrees. Once the law states that it will countenance doctors prescribing death, the details about who receives the poison–and the circumstances surrounding the prescribing (or administration)–increasingly don’t matter. Ending suffering–as defined by the suicidal person–becomes the paradigm. In that milieu, people stop caring because protecting the vulnerable doesn’t matter.
December 8th, 2011 | 3:09 pm
Thanks to a good and decent human being who happens to be a Doctor and who has the knowledge and the courage to point out that “Assisted Suicide” is a flawed process that is wrong morally and medically and ethically!
Legalizing “Assisted Suicide” and the human indulgences that it serves really does cheapen “life” and paints “death” as the friend, rather than the enemy to be defeated, whenever possible. It is instintive to fight to live –to fight death –and the state has always protected this instinct under the law.
I can see how the 1991 Patient Self-Determination Act has lead to unilateral justification of passive euthanasia of the elderly. Because of the reimbursement policies and protocols of Medicare and the Private Insurers hospitals have a financial incentive to send patients to eternity sooner rather than later in defense of their bottom lines.
Legalizing Abortion led to more abortions, unfortunately! Legalizing Assisted Suicide will lead to more suicides, unfortunately! Legalizing elective passive euthanasia with the 1991 Patient Self Determination Act of 1991 set up the slippery slope.
Pro-choice concerning this issue will, of course, lead to “no choice” as you predicted those many years ago when they started talking about “medical futility” and end-of-life choices.
December 8th, 2011 | 4:18 pm
But Victor! “IT” is not my fault!
Not mine either! :)
Then who’s fault is “IT”, Victor?, I mean sinner vic? :( $ :)
Peace
December 8th, 2011 | 5:40 pm
Spot on, Dr. Bentz (and Wesley).
December 8th, 2011 | 9:31 pm
Don’t you always love it when some well-intentioned busybody tries to tell you what you should and shouldn’t do with your own life? If you don’t believe in suicide then by all means don’t commit it. If you think there’s edification in intractable pain, then by all means suffer. But people should at least have the common decency to keep their long noses out of other people’s business.
HW
Janine Reply:
December 9th, 2011 at 9:44 pm
@HistoryWriter,
I would have no issue keeping my nose out of other peoples business if they kept their business to themselves. By all means, if you want to die, kill yourself. None of my business.
But they want someone else to help them do it. It has now gone beyond being their business just by the fact that there is more than them involved.
December 8th, 2011 | 9:55 pm
Wow. It appears from the letter that this primary care doc diagnosed and charted his patient as depressed, was on notice that his depressed patient had asked a cancer specialist about suicide–and then did nothing to stop it from happening! After his discussion with the oncologist, he didn’t order a psych referral for the depression he’d diagnosed; he didn’t go talk to his patient; indeed, he doesn’t seem to have done anything at all to respond to what he now calls his patient’s “cry for help.” “The only help my patient got was a lethal prescription,” he says. Exactly.
Kathleen Lundquist Reply:
December 10th, 2011 at 11:31 pm
@Stephen Latham,
It appears to me from the letter that Dr. Bentz was not the one who diagnosed the patient’s depression, but rather he only found out about the patient’s attitude toward his cancer diagnosis after the patient entered into a course of therapy with the oncologist, who documented the patient’s depressed feelings in _his_ chart. (According to common practice, the oncologist would have sent a copy of his chart notes on the patient to Dr. Bentz, the primary care physician, on a regular basis.)
It can take several weeks for a primary care doc and patient to arrange a psych eval, even if the patient cooperates with the referral (and with one doctor already on board to sanction his suicide, it’s nowhere near clear that the patient did or would have gone to one if Dr. Bentz arranged it).
It’s patently unfair to blame Dr. Bentz for his patient’s suicide. The blame rests with the patient and the oncologist who wrote the lethal prescription – or rather, if you’re looking for more people to share the blame, you should include every registered voter in the state of Oregon who let him-/herself be swayed by wrongheaded, fatalist, emotional arguments in favor of the DWDA.
December 9th, 2011 | 9:29 am
@HistoryWriter,
Hi HistoryWriter!
________________________
Hey! He’s not that hi Victor!
_________________________________
Leave me alone sinner vic cause I want to have a heart to heart talk with this good man.
_________________-_++___________
What are you on anyway Victor? Personally speaking, you’re a perfect example for leagalizing Euthanasia. Just cause you want to suffer in this body of yours is no reason why the rest of U>S (usual sinners) must go along with “IT”! Don’t you think?
___________________________________
What Ever sinner vic! NOW can I have my say? Please!!!!
——————————————–
Listen here sinner vic, Long story short, I saw my dad die and a few other friends suffer a great deal in reality for years at a time so I thought but whenever I looked them in the eyes and call me crazy but I could almost hear them say with LOVE, Thank you for not taking my life.
_________________________________
Come on Victor! That was just Our L.S.D. talking which took all their pain away.
__________________________________
Gee sinner vic that was deep! I had a funny feeling that you also believed in Our Loving Saving Dad but I never thought that you would put “IT” down in writing?
So what do you say HistoryWriter! Do you still think that we should continue legalizing Euthanasia and/or Legalizing “Assisted Suicide” ?
I hear ya! You bunch of so called christian “Hypocrites”
__________________________________
Stop putting words in my mouth Victor or is “IT” sinner vic? :)
_________________________________
Peace
Shalom
December 9th, 2011 | 11:25 am
[...] Assisted Suicide Guidelines Don't Protect Once Prescribed Death is LegalizedFirst Things (blog)From “Oregon's Assisted Suicide Law Isn't Working” published in the The Provence (BC, Canada): I am a doctor in Oregon, where physician-assisted suicide is legal. I disagree that Oregon's law has worked well. As one example, a few years ago, … [...]
December 9th, 2011 | 1:31 pm
Not too long ago we were told how an adult had impersonated a teenager and through an internet relationship had pushed an already emotionally vulnerable girl into committing suicide. Maybe she can hire herself out as a hitman to help get rid of inconveniently living Oregonians who are resented by various social enemies. Then we can see if the normal law that excuses homicide in defense if others wil protect the person who ends the life of the internet suicide inducing hitman.
December 9th, 2011 | 1:54 pm
[...] Smith at Secondhand Smoke | A First Things Blog: This letter to the editor from a physician about the failure of Oregon’s doctor-prescribed [...]
December 10th, 2011 | 3:31 pm
Yes! these people who support the CHOICE of human beings to commit suicide and want to make it legal for physicians to assist in the suicides must not understand the negative implications for society.
This door was opened in 1991 when the Patient Self-Determination Act was passed by the Congress —but this act, of course, (strangely) only applied to Hospitals —and not to physicians.
Under the Act and for the first time, inpatient hospital patients could elect, under State laws, NOT to have certain intervening life-extending and life-saving treatments and, therefore, die in the hospitals sooner rather than later. Or, elect to go to a Nursing Home or to their residence on Hospice Care or Home Care under Medicare and die at less cost to the insurers and to government.
The rationale was that these voluntary “No CPRs” (that result in DNR/DNI code) would save the patients from pro-longed suffering and ALSO would save the insurers and the government from the expense of prolonging the lives of the elderly and terminally ill in the ICUs of the nation’s Acute Care Hospitals.
Administrative Rules, etc.. concerning reimbursement to hospitals are inviting untilateral DNR/DNI code status to be placed in charts of patients to save money for the hospitals.
BUT, of course the patients, under current law, have to agree to die sooner rather than later. Under law, their lives cannot be shortened without their informed consent, or the consent of their surrogate decision maker.
The election for Hospice Care is in a certain sense a a voluntary election to die sooner rather than later in many instances and is a constructive form of rationing of “end of life” expensive procedures to conserve resources and save money for the insurers and the government. But, of course, OUTPATIENT care is not rationed because to ration outpatient care would ration PROFITS.
If physicians had been put under the 1991 Patient Self Determination Act, there would be some voluntary “patient” rationing of outpatient treatment because physicians would have had to seek “informed consent” for end-of-life outpatient care. Informed consent for end-of-life outpatient care would, of course, lead to rationing of profits.
NOW, if Assisted Suicide, which is againat the law in most all states, is widely approved the door will be wide open or “off the hinges” and there will be an increasing use of the unilateral and secret DNRs by physicians that will send the elderly and vulnerable off sooner rather than later to save money and preseve profits for the “for-profit” health care system now in place. The physicians will feel even safer than they do now from any legal consequences for unilateral decisions.
Oregon should repeal its Assisted Suicide Law –and would –if the citizens really understood the implications to society of treating human life as cheap and not worth saving. Never know when the “better off dead” crowd might come looking for THEM to protect profits and solve the fiscal problems of our health care system.
December 10th, 2011 | 9:10 pm
HW-you are a cold, cold fish.
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